Written Answers Nos. 430-452
430. Deputy Eamon Scanlon asked the Minister for Health when an increase in home support will be in place for a person (details supplied) in County Sligo; and if he will make a statement on the matter. [27777/19]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
431. Deputy John Brassil asked the Minister for Health if the case of a person (details supplied) will be reviewed in order to sanction funding for therapy via CAMHS; and if he will make a statement on the matter. [27789/19]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
432. Deputy Mary Butler asked the Minister for Health when a replacement staff member will be appointed for the position of speech and language therapist in the west Waterford network 1 area while the existing speech and language therapist is on maternity leave in order that there is no gap in the service; and if he will make a statement on the matter. [27791/19]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
433. Deputy Noel Rock asked the Minister for Health if the case of a person (details supplied) regarding an assessment of needs application will be investigated; and if he will make a statement on the matter. [27824/19]
Amharc ar fhreagraThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities. As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
434. Deputy James Browne asked the Minister for Health the position regarding a health unit (details supplied); his future plans for its use; and if he will make a statement on the matter. [27838/19]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to you directly, as soon as possible.
435. Deputy Michael Moynihan asked the Minister for Health when a decision will be made on reimbursement for the drug osimertinib for treatment of advanced lung cancer; the steps being taken to expedite this assessment; and if he will make a statement on the matter. [27853/19]
Amharc ar fhreagraThe HSE has statutory responsibility for medicine pricing and reimbursement under the Health (Pricing and Supply of Medical Goods) Act 2013. The Act specifies the criteria for decisions on the reimbursement of medicines. As Minister for Health, I have no role or powers in relation to such matters.
Decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds by the HSE, including advice from the National Centre for Pharmacoeconomics (NCPE).
The NCPE conducts health technology assessments (HTAs) of medicines for the HSE and makes recommendations on reimbursement to assist the HSE in its decision-making process. The NCPE uses a decision framework to systematically assess a drug's clinical and cost effectiveness as a health intervention at the submitted price.
The HSE has a robust assessment and commercial negotiation process for new medicines. This process challenges inappropriate costings from applicant companies and delivers improved value for money on new medicines, allowing more treatments to be provided within a finite budget.
The HSE strives to reach a decision in as timely a manner as possible. However, because of the significant monies involved, it must ensure that the best price is achieved, as these commitments can be ongoing multi-million euro investments. If the HSE were not to challenge pharmaceutical companies pricing fewer medicines could be provided from the resources provided.
I am advised by the HSE that it has received applications for the following indications for osimertinib.
1. The treatment of adult patients with locally advanced or metastatic EGFR T790M mutation-positive NSCLC.
In respect of this indication, the HSE received a health technology assessment (cost utility analysis) for this application in May 2018.
A summary copy of that report is available on the NCPE website (www.ncpe.ie) @ http://www.ncpe.ie/wp-content/uploads/2018/05/NCPE-summary-osimertinib-final-draft.pdf.
Following the assessment and after a number of rounds of commercial negotiations and HSE reviews, the HSE notified the applicant in February 2019 that it was minded to not approve osimertinib for the second line treatment of EGFR T790M mutation-positive non-small-cell lung cancers.
The Health (Pricing and Supply of Medical Goods) Act 2013 requires a period of representations after such notifications, before the HSE makes any formal final decision. The HSE reviewed representations received at its May 2019 meeting and is currently considering this.
2. The first-line treatment of adult patients with locally advanced or metastatic non-small cell lung cancer with activating epidermal growth factor receptor (EGFR) mutations.
In respect of this indication, a health technology assessment is ongoing. Details on progress through the HTA process are published on the NCPE website @ http://www.ncpe.ie/drugs/osimertinib-tagrisso-for-the-first-line-treatment-of-metastatic-nsclc/.
436. Deputy Michael McGrath asked the Minister for Health if the HSE and CervicalCheck have sought a reassurance from a laboratory (details supplied) that the personal details of Irish women availing of the CervicalCheck screening programme were not exposed as part of the recent statement by the company concerning a significant data breach; and if he will make a statement on the matter. [27864/19]
Amharc ar fhreagraIn early June 2019 there were media reports of a data breach issue in one of the laboratories contracted to provide services to CervicalCheck, Quest Diagnostics. This breach involved a third-party payment service. The HSE advises that its arrangement with Quest Diagnostics does not involve any third-party payment providers as payment for services is made directly to Quest Diagnostics.
The HSE advises that it has confirmed with Quest that the nature of the data breach does not impact on Irish cytology slides processed for CervicalCheck.
437. Deputy Robert Troy asked the Minister for Health if an appointment will be expedited for a person (details supplied). [27873/19]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
438. Deputy Mary Lou McDonald asked the Minister for Health the number of live studies, reviews and research undertaken or commissioned by him; and the date by which each study, review and research is scheduled to be completed. [27884/19]
Amharc ar fhreagraThe information requested by the Deputy is not immediately available. I will survey the Department and the collated replies will be prepared into a full response to the Deputy as soon as possible.
439. Deputy Charlie McConalogue asked the Minister for Health when a replacement scheme will be announced for the mobility allowance and motorised transport grant; the reason for the delay in finalising same to date; and if he will make a statement on the matter. [27908/19]
Amharc ar fhreagra509. Deputy Bernard J. Durkan asked the Minister for Health the progress to date in determining the appropriate scheme to replace the mobility allowance and motorised transport grant; and if he will make a statement on the matter. [28247/19]
Amharc ar fhreagraI propose to take Questions Nos. 439 and 509 together.
The Deputies will be familiar with the background to the closure of both the Mobility Allowance and Motorised Transport Grant schemes in 2013.
With regard to the proposals for a new Health (Transport Support) Bill, the Deputies may be aware that my colleague, the Minister for Health and I, brought a Memorandum to Government on proposals for a new Transport Support Payment Scheme. Following consideration of the matter, it was decided to withdraw the Memorandum from the Cabinet Agenda at that time. I intend to revert to Government in due course with revised proposals to reflect the discussions at that Cabinet meeting and further discussions between myself and Minister Harris, on the best way to progress the Transport Scheme.
It is important to note that the Disabled Drivers and Disabled Passengers scheme, operated by the Revenue Commissioners, remains in place. This scheme provides VRT and VAT relief, an exemption from road tax and a fuel grant to drivers and passengers with a disability, who qualify under the relevant criteria set out in governing regulations made by the Minister for Finance. Specifically adapted vehicles driven by persons with a disability are also exempt from payment of tolls on national roads and toll bridges. Transport Infrastructure Ireland has responsibility for this particular scheme.
There are improvements in access to a range of transport support schemes available to persons with disabilities in the State and on-going work is being carried out by Government Departments, agencies and transport providers to further improve access to public transport services. Under the National Disability Inclusion Strategy, the Department of Transport, Tourism and Sport has responsibility for the continued development of accessibility and availability of public transport for people with a disability.
440. Deputy Pearse Doherty asked the Minister for Health if a person (details supplied) in County Donegal is on the routine or urgent waiting list to attend Crumlin Hospital; and if he will make a statement on the matter. [27911/19]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly
441. Deputy Pearse Doherty asked the Minister for Health if a person (details supplied) in County Donegal can be considered for an earlier appointment; and if he will make a statement on the matter. [27912/19]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
442. Deputy Tom Neville asked the Minister for Health the documents published by his Department since 1 January 2016 (details supplied); and if he will make a statement on the matter. [27915/19]
Amharc ar fhreagraThe information requested by the Deputy is not immediately available. I have surveyed the Department and the collated replies will be prepared into a full response to the Deputy as soon as possible.
443. Deputy David Cullinane asked the Minister for Health the number of whole-time equivalent consultant orthodontists in the south-east in each of the years 2014 to 2018 and to date in 2019, by county (details supplied), in tabular form; and if he will make a statement on the matter. [27927/19]
Amharc ar fhreagraI have asked the HSE to respond directly to the Deputy on this matter.
444. Deputy Michael McGrath asked the Minister for Health the projected cost of the national children’s hospital in each of the years 2021 to 2024; and if he will make a statement on the matter. [27949/19]
Amharc ar fhreagraIn terms of the financing of the children’s hospital project for 2019, €250m is included in capital profiles for the project in 2019.
The Summer Economic Statement, published recently, provides an expenditure reserve of up to €200m in 2020 to accommodate funding requirements for the new Children's Hospital and the National Broadband Plan. My Department will engage with the Department of Public Expenditure and Reform and the HSE in planning funding for the new Children's Hospital beyond 2019.
445. Deputy Michael McGrath asked the Minister for Health if the cost of the national children’s hospital is €1.73 billion as mentioned in a report (details supplied); and if he will make a statement on the matter. [27950/19]
Amharc ar fhreagraI advised Government in December 2018 that the overall cost to complete the capital project is €1,433m, this includes all of the capital cost for the main hospital at St James's Hospital campus which will house the school and third level educational spaces, the two OPD and urgent care centres at Connolly and Tallaght Hospital campuses, equipment for the three sites, and the construction of the carpark and retail spaces.
The €1.7 billion includes the capital cost plus investment in ICT and the Electronic Health Record rollout - funded through the ICT capital programme, the comprehensive Children's Hospital Integration Programme which is well underway - ensuring the successful clinical and operational merging of three paediatric hospitals - pre-2013 project expenditure relating to the former Mater project, and the planned construction of the Children’s Research and Innovation Centre to be funded through philanthropic funding.
446. Deputy Jackie Cahill asked the Minister for Health if he will address a matter (details supplied) regarding home help staff in County Tipperary. [27968/19]
Amharc ar fhreagraI have asked the HSE to respond directly to the Deputy on this operational matter.
447. Deputy Maureen O'Sullivan asked the Minister for Health if there are active guidelines on the use of defibrillators on infants; and if so, if they are being applied. [27971/19]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
448. Deputy Maureen O'Sullivan asked the Minister for Health if he has considered proton beam therapy in the treatment of cancerous tumours; and if he will make a statement on the matter. [27972/19]
Amharc ar fhreagraProton beam therapy is an advanced form of radiotherapy, primarily used in neural and some paediatric cancers.
Currently in Ireland, patients are referred abroad for proton beam therapy to preferred providers. Between 2012-2017 an average of 11 patients a year were referred for proton beam therapy in treatment centres abroad under the Treatment Abroad Scheme. This represents an extremely small proportion of Irish patients who are receiving radiotherapy.
In February 2019, a National Proton Group was set up by the National Cancer Control Programme, with a mandate to progress and give due consideration to proton therapy. The work of the National Proton Group includes:
- Carrying out an evidence review of the current clinical indications for proton therapy treatment
- Designing a clinical pathway from Multi-Disciplinary Team to proton therapy services
- Developing a service specification and commissioning framework for any new developments which may happen in Ireland.
The National Cancer Control Programme will continue to monitor the evidence base for proton beam therapy and the number of Irish patients being referred abroad, as well as developments in technology that may impact on the viability of providing this treatment here.
449. Deputy Maureen O'Sullivan asked the Minister for Health the position regarding the health hazards of nitrates in food; and if he will make a statement on the matter. [27973/19]
Amharc ar fhreagraI am advised by the Food Safety Authority of Ireland (FSAI) that Nitrate is found naturally in vegetables. It can also enter the food chain as an environmental contaminant in water, due to its use in intensive farming methods, livestock production and sewage discharge. In humans, nitrite and nitrate from food are rapidly absorbed by the body and, for the most part, excreted as nitrate. Some of the nitrate absorbed by the body is converted in the body into nitrite, the absorption of which can lead, in excessive quantities, to a reduced ability of red blood cells to bind and transport oxygen through the body. Nitrite in food (and nitrate converted to nitrite in the body) may also contribute to the formation of a group of compounds known as nitrosamines, some of which are carcinogenic.
For decades the salts of nitrate and nitrite have been added to food to preserve it and they also help hinder the growth of harmful microorganisms. The use of additives in food is strictly controlled by EU legislation. They must undergo a comprehensive scientific safety assessment before being authorised for use in the manufacture or preparation of foodstuffs. The natural occurrence of nitrate in foods such as vegetables is regulated by maximum levels set out in EU Regulation 1881/2006 as amended.
The FSAI has indicated that the safety of nitrate has been comprehensively evaluated by European Union (EU) and International Scientific Experts, including the European Food Safety Authority (EFSA) and the Joint Expert Committee on Food Additives (JECFA), an international expert scientific committee that is administered jointly by the Food and Agriculture Organisation of the United Nations and the World Health Organisation.
In a re-evaluation on the safety of nitrate, EFSA concluded in 2017 that the exposure to nitrate resulting from its use as a food additive did not lead to an exceedance of the Acceptable Daily Intake (ADI) and was estimated to be less than 5% of the overall exposure to nitrate in food from all dietary sources. However, EFSA noted that total dietary exposure to nitrate from all sources (food additives, natural presence and contamination) exceeded the current ADI in all European populations considered. Similar conclusions were drawn concerning dietary exposure to nitrites from all sources.
An assessment carried out by EFSA in 2008 on nitrates present in food as contaminants compared the risk and benefits of exposure to nitrate from vegetables and concluded that the beneficial effects outweighed potential health risks from exposure to nitrate through vegetables, and that the average European consumer would not exceed the ADI.
In 2010, a further opinion was delivered on the potential health risks for infants and young children from naturally occurring nitrate in leafy vegetables, which concluded that levels of nitrate in these vegetables do not pose a health concern for most children.
As previously noted, nitrites, including when used as food additives, contribute to the formation of nitrosamines. Applying some worst-case scenario assumptions, EFSA concluded that the formation of nitrosamines in the body from use of food additives at approved levels was of low concern for human health. However, EFSA further noted that nitrite unintentionally present in meat products from other sources such as environmental contamination can also contribute to the formation of nitrosamines. EFSA concluded that these levels of nitrosamines might give rise to potential health concerns but that more research was needed to address uncertainties and knowledge gaps that may exist in this area.
According to the most recent Irish Total Diet study performed by the FSAI between 2012 to 2014, exposure estimates to both nitrite and nitrate in adults and children resident in Ireland were found to be below the respective health-based guidance values. The study identified vegetables as the most important dietary contributor for nitrate, and ham as the only dietary contributor for nitrite. The study concluded that exposure to nitrates and nitrites from food is not of concern.
450. Deputy Maureen O'Sullivan asked the Minister for Health the status of correspondence he has had with a group (details supplied) with regard to changes requested to the assisted human reproduction Bill concerning changes to the law to be more inclusive of LGBT+ families; and if he will make a statement on the matter. [27974/19]
Amharc ar fhreagraIn October 2017, the Government approved the drafting of a Bill on assisted human reproduction (AHR) and associated areas of research, based on the published General Scheme of the Assisted Human Reproduction Bill. The Joint Oireachtas Committee on Health is currently conducting a review of the General Scheme as part of the pre-legislative scrutiny process, which began in January of last year. The Joint Committee intends to report thereon before the summer recess.
The aim of the AHR legislation is to promote and ensure the health and safety of parents, others involved in the process (such as donors and surrogate mothers) and, most importantly, the children who will be born as a result of AHR. Consideration of the welfare and best interests of children born through AHR is a key principle underpinning the General Scheme. Subject to certain conditions being met, AHR treatments will be available to people irrespective of gender, marital status or sexual orientation.
My officials and I have engaged with LGBT Ireland (the group referred to by the Deputy) in relation to provisions within both the General Scheme of the Assisted Human Reproduction Bill and Parts 2 & 3 of the Children and Family Relationships Act 2015. As part of this process of engagement, LGBT Ireland also made a formal submission to my Department in relation to these matters.
Given the comprehensive scope of the legislation and the ethical, legal and social issues which arise from AHR practices, it is anticipated that certain areas of the General Scheme will require further consideration and refinement during the ongoing process of drafting the Assisted Human Reproduction Bill in conjunction with the Office of the Attorney General. An analysis of the Joint Committee’s report on the General Scheme, once completed, and the response of stakeholders, including LGBT Ireland, will feed into this process.
451. Deputy Maureen O'Sullivan asked the Minister for Health when he will review the decision regarding making flash glucose monitoring technology available to persons with type 1 diabetes; if the survey he received from an organisation (details supplied) has been considered when examining the merits of FreeStyle Libre technology; and if he will make a statement on the matter. [27975/19]
Amharc ar fhreagraUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
452. Deputy Gino Kenny asked the Minister for Health his views on the negative impact experienced by 2,500 children waiting for long periods for an appointment with mental health services; and if he will make a statement on the matter. [22694/19]
Amharc ar fhreagraEnhancement of the specialist CAMHS service, including improved access and reducing waiting lists, remains a priority for both the Government and the HSE.
The total number of children on the CAMHS Waiting List was around 2,606 at the end of April 2019. This was down from 2,711 in April 2018. The HSE has prioritised reducing both short- and long-term CAMHS waiting lists. This has helped to reduce the waiting lists of those waiting over 12 months, which has reduced from 352 in April 2018 to 316 in April this year. In April 2019 approximately 80% of young people were offered a first appointment within 12 weeks in community CAMHS settings
It is important to note that the number of referrals to CAMHS increased from around 12,800 referrals received in 2011 to around 18,100 referrals expected in 2019. Cases assessed by professionals as urgent are seen as a matter of priority.
The recent Budget provided an additional €55 million to progress new developments in mental health which brings overall HSE mental health funding to nearly €1 billion in 2019. This funding has helped to increase services available in this area.
There are now 70 CAMHS teams, compared to 49 in 2008, and 3 Paediatric Liaison Teams. All aspects of CAMHS nationally are being improved by the HSE under its annual Service Plans. This includes better out-of-hours and 7/7 day cover, progression of Day Hospital care, developing specialist teams such as Eating Disorders, and improved Prevention and Early Intervention services.
To this end, we have also tried to reduce demand on CAMHS. The HSE funds Jigsaw to provide early intervention mental health services which focus on the needs of 12-25 year olds. Their early intervention model provides tangible supports for young people at primary care level who have mild and emerging mental health difficulties. There are currently 13 Jigsaw Services in communities across Ireland providing mental health support to young people with 2 more sites in Wicklow and Tipperary expected to be opened in the next year .
In conjunction with the Department of Health and the HSE, I am progressing various initiatives to enhance CAMHS, and also to adopt a wider approach around Prevention and Early Intervention measures, designed to alleviate pressures on the specialist CAMHS service. These include maximising the impact of the additional Primary Care Assistant Psychologists recruited in 2018 to relieve pressures on CAMHS; roll-out by the HSE of various e-mental health pilot projects; and additional Psychiatric Nurse training places coming on-stream to help fill existing vacancies.
The Department of Health will continue to monitor CAMHS activity and staffing data. In addition, I have held meetings with, and sought further information from, the Chief Officers and Executive Clinical Directors of the CHOs specifically on CAMHS vacancies, with a view to improving the rate of recruitment for CAMHS staff.
